OBSIDIAN HEALTH AND WELLNESS LLC NPI 1417593575

NPI Information

NPI: 1417593575
Provider Name: OBSIDIAN HEALTH AND WELLNESS LLC
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
13321 W INDIAN SCHOOL RD STE A107
LITCHFIELD PARK, AZ
ZIP 85340
Phone: (623) 293-2232
Get Directions

OBSIDIAN HEALTH AND WELLNESS LLC is an adult mental health clinic center in Litchfield Park, AZ. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. OBSIDIAN HEALTH AND WELLNESS LLC NPI is 1417593575. The provider is registered as an organization entity type.

The provider's business location address is:

13321 W INDIAN SCHOOL RD STE A107
LITCHFIELD PARK, AZ
ZIP 85340-339
Phone: (623) 293-2232
Fax: (623) 321-9524

The provider's authorized official is Deborah Grace .
The authorized official title is Consultant and has the following contact phone number (602) 696-3556.

The enumeration date for this NPI number is 11/25/2019 and was last updated on 11/25/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0850X	Clinic/Center	Adult Mental Health			Yes
2	261QM0855X	Clinic/Center	Adolescent and Children Mental Health			No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	435346	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »